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Non-Alcoholic Fatty Liver Disease (NAFLD)

NAFLD is a common disease of the liver. It occurs when there is too much fat in the liver. If NAFLD is severe, it can cause liver damage similar to the damage caused by drinking too much alcohol. However, NAFLD is not caused by drinking alcohol. This sheet tells you more about NAFLD and how it can be managed.

images of healthy liver, fatty liver, and liver with NASH

How the Liver Works

The liver is an organ located in the upper right side of the abdomen. It has many important functions. These include:

  • Metabolizing proteins, carbohydrates, and fats

  • Making a substance called bile that helps break down fats

  • Storing and releasing sugar (glucose) into the blood to give the body energy

  • Removing toxins from the blood

  • Helping with the clotting of blood

Understanding NAFLD

A healthy liver may contain some fat. But if too much fat builds up in the liver, this causes NAFLD. NAFLD can be mild, causing fatty liver. Or it can be more severe and show inflammation, as well as the fat, and cause non-alcoholic steatohepatitis (NASH). NASH can lead to cirrhosis. With fatty liver, the liver simply contains more fat than normal. This extra fat usually causes no damage to the liver. With NASH, the fatty liver becomes inflamed over time. NASH is serious because it can lead to hardening and early scarring of the liver (fibrosis). If the fibrosis worsens, it can cause complete scarring of the liver (cirrhosis). This can eventually cause liver failure or liver cancer.

Causes and Risk Factors of NAFLD

The cause of NAFLD is unknown. But certain risk factors make the problem more likely to occur. These include:

  • Obesity

  • Prediabetes or diabetes

  • High levels of cholesterol and triglycerides (types of fat found in the blood)

  • Exposure to certain medications 

Symptoms of NAFLD

Most people with NAFLD have no symptoms. If symptoms do occur, they can include:

  • Tiredness

  • Weakness

  • Weight loss

  • Loss of appetite

  • Nausea and vomiting

  • Abdominal pain and cramping

  • Yellowing of the skin and eyes (jaundice); dark urine, or light-colored stools

  • Swelling in the abdomen or legs

Diagnosing NAFLD

The doctor may suspect you have NAFLD if routine blood tests show high levels of liver enzymes. This means that a liver problem is likely. One or more imaging tests, such as an ultrasound, CT scan, or MRI scan, may be done to check for NAFLD. A liver biopsy may also be done. During this test, a hollow needle is used to remove a tiny amount of tissue from the liver. This tissue is then studied in a lab. This test can detect signs of damage involving liver tissue. It can also help determine the cause of the damage and tell the difference between fatty liver and NASH.

Treating NAFLD

Treatment for NAFLD varies for each person. Your doctor will monitor your health and treat any symptoms or underlying health problems you have. Your doctor will also work with you to control your risk factors so that damage to your liver is less likely. Your plan may include:

  • Losing excess weight

  • Getting regular exercise

  • Controlling diabetes and high cholesterol or triglyceride levels

  • Taking medications and vitamins as prescribed by your doctor

  • Quitting smoking

  • Avoiding drinking alcohol

  • Eating a healthy and balanced diet

Living with NAFLD

If NAFLD is caught early, it can be managed to help reverse the liver damage. Your health care provider will discuss further treatment options with you as needed.

Online Medical Reviewer: Goldblum, Lester F, MD, DO, PC
Online Medical Reviewer: Sundberg, Richard A, MD
Last Review Date: 11/1/2011
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